2020国际护士报告ICN

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The 146th WHOExecutive Board MeetingICN Report3-7 February 2020


International Council of NursesPrepared by:Hoi Shan Fokeladeh, Policy Adviser

IntroductionThe 146th World Health Organization (WHO) Executive Board Meeting took place 3-7 February2020 at WHO Headquarters in Geneva, Switzerland. The representatives of 34 member statesmake up the Executive Board (EB) and are elected for three-year terms. The annual EB meetingagrees upon the agenda of and the resolutions to be considered by the World Health Assembly(WHA) . The main functions of the Board are to implement the decisions and policies of the WHA,and to advise and generally facilitate its work.ICN’s special status with WHO means its delegates are able to intervene in a number of theEB debates about critical areas of healthcare where nurses make a vital contribution to theachievement of WHO’s goal of ‘Health for All’. ICN closely follows the work of WHO and send adelegation to the EB to attend meetings and deliver statements. In 2020, ICN addressed the EBmeeting, delivering statements on four agenda items which were uploaded to the ICN website andcan also be found in this report.The WHO Secretariat indicated that there were 52 items in the agenda with 20 draft resolutionsor decisions expected. The agenda items covered the following subjects: primary health care,universal health coverage, engagement with non-States actors, cervical cancer, tuberculosisresearch and innovation, healthy ageing and digital health.

Report of the Director-General,146th Meeting of the Executive BoardIn the opening remarks of the EB meeting, WHODirector-General (DG), Dr Tedros AdhanomGhebreyesus presented a wide-rangingreview of challenges, transformation andaccomplishments from 2019. He highlighted2020 as the Year of the Nurse and the Midwife,recognising the incredible roles nurses andmidwives play and emphasising that healthworkers are vital to achieving universal healthcoverage, especially nurses and midwives.“We’re calling on all countries to invest in nursesand midwives as part of their commitment touniversal health coverage. This year, WHOwill also publish its first report on The State ofthe World’s Nursing, to provide a “snapshot”of the global nursing workforce. We hope thatcountries will use the data from this report tomake evidence-based decisions on how andwhere to invest in the nursing and midwiferyworkforce.”Dr Tedros also called for solidarity amongstWHO member states to meet the challengesof the novel coronavirus epidemic. He calledon countries to implement decisions that areevidence-based and consistent. He emphasisedthe importance to combat the spread of rumoursand misinformation and the need to supportcountries with weaker health systems. Universalmeasures should include policies to reviewpreparedness plans, identify gaps and evaluatethe resources needed to identify, isolate andcare for cases, and prevent transmission.“We call on all countries to share data,sequences, knowledge and experience withWHO and the world. The only way we will defeatthis outbreak is for all countries to work togetherin a spirit of solidarity and cooperation. We are inthis together, and we can only stop it together.”

ICN DelegationThe ICN delegation to the 146th EB meeting consisted of:• Howard Catton, ICN CEO• Alessandro Stievano, ICN• Hoi Shan Fokeladeh, ICN• Dr Madeline A. Naegle, NYU• Dr Franklin A. Shaffer, CGFNS International

Agenda Item 6: Primary Health Care• In response to the request in resolutionWHA72.2 (2019) on primary healthcare (PHC), EB146/5 conveyed adraft operational framework for PHC inorder to strengthen health systems andsupport countries in scaling up nationalimplementation efforts. The frameworkis aimed at a range of actors, includingnational and subnational governmentleaders, and non-States actors.• The demonstrated links of PHC to betterhealth outcomes, improved equity,increased healthy security and better costefficiency make PHC the cornerstone ofhealth systems strengthening. There isan unprecedented political movementfor health systems to build on thefoundations of PHC which is essentialto achieve universal health coverage(UHC). The new operational frameworkoutlines 14 operational levers thatcomprise all the components of PHC.The expansion of PHC services is one ofthe key accelerators of the health-relatedSustainable Development Goals (SDGs)and the special programme will providedifferentiated support to countries,particularly with fragile health systems.Documents: EB146/5Draft operational framework Primary health care: transforming vision into action• Member States recognised that PHCis a major component to achieve theSDGs and UHC. They also welcomedthe Astana declaration and endorsedthe WHO Global Action Plan for Healthfor All. The DG emphasized politicalcommitment from the highest level iscrucial to push PHC forward and WHO iswilling to provide support to the MemberStates.• The draft decision proposed byBotswana, Brazil, Islamic Republic ofIran, Kazakhstan, Mexico and Tajikistanwas adopted as EB146(18) PrimaryHealth Care.• ICN strongly supports the implementationof the WHO’s special programme on PHC.Nurses make incredible contributions toPHC on a daily basis and are the agentsto effectively engage the community as anactor in the development of interventionsand action. Full ICN statement is here

Agenda Item 7.1: Follow-up to the high-level meetings of the United NationsGeneral Assembly on health-related issues. Universal health coverage:moving together to build a healthier world

Documents: EB146/6Universal health coverage: moving together to build a healthier world
EB146/6 recalled the Political Declarationof High Level Meeting of the Unitednations General Assembly on UHC inSeptember 2019. With the foundationof PHC, UHC is universal access toa strong and resilient people-centredhealth system. In the WHO’s 2019monitoring report, all regions and allincome groups recorded gains, but thepace of progress has slowed since 2010and the progress masks gross inequities.Other monitoring reports also highlightthe significant health challenges affectingthe most vulnerable population groups,for instance, children under five years ofage and pregnant women. The reportsalso call for a sharper focus on people leftbehind and an increase in investmentsin generating high-quality, disaggregateddata to help ensure accountability andprovide countries with vital insights intothe population that is unable to accessessential health services.Documents: EB146/6Universal health coverage: moving together to build a healthier world• Member States recognised UHC ascentral to SDGs and the role of WHO iscritical. Health equity should be focused,especially for vulnerable populations.Health systems should also respondto demographic shifts like ageingpopulations. Some Member Statessuggested providing stronger supportto health care workers. The DeputyDirector General stated that SDG 3.8(catastrophic expenditures and out ofpocket expenditure) has not improvedand it is important for Member States tomobilise national resources. The DG saidit is crucial to take the opportunity to scaleup the action at the country level. The EBnoted the report without objections.• World Health Professionals Alliance(WHPA) Joint statement.

  Agenda Item 7.2: Political declaration of the Third High-Level Meeting of theGeneral Assembly on the Prevention and Control of Non-CommunicableDiseases
Documents: EB146/7Political declaration of the third high-level meeting of the General Assembly on the prevention andcontrol of non-communicable diseases / EB146/7 Add. 1 Findings of the consultative process onthe implementation of the global strategy to reduce the harmful use of alcohol and the way forward

The report was submitted pursuant todecision WHA72(11) (2019), in which theWHA requested the DG to prepare andupdate menus of policy options and costeffective interventions to support MemberStates in implementing the actions onthe prevention and control of NCDs.Four separate issues were consideredregarding NCDs: mental health; airpollution; alcohol; and early diagnosisand interventions for NCDs. There is anew WHO roadmap for reducing harmfulalcohol consumption. It was noted thatthere is worldwide increase in harmfulalcohol consumption, particularly in lowand middle-income countries.• Civil society noted that harmful alcoholconsumption claims as many as threemillion lives a year, either directly orthrough cancer, liver disease, heartattack, etc.• Member States expressed concern aboutthe diseases linked to alcohol, suchas cancer. Some also mentioned theimportance of cross-border collaborationto address the harmful use of alcoholeffectively. Draft decision EB146/Conf/1Rev.1 was adopted.• ICN welcomed the strong emphasison mental health promotion in the NCDagenda and fully supports the menuof policy options and mental healthinterventions. Nurses have expertise inholistic, person-centred care and mentalhealth interventions which broadenthe therapeutic outcomes for complexcomponents of chronic illness. Read thefull ICN statement here.

Agenda Item 6: Primary Health Care
Documents: EB146/5Draft operational framework Primary health care: transforming vision into action

In response to the request in resolutionWHA72.2 (2019) on primary healthcare (PHC), EB146/5 conveyed adraft operational framework for PHC inorder to strengthen health systems andsupport countries in scaling up nationalimplementation efforts. The frameworkis aimed at a range of actors, includingnational and subnational governmentleaders, and non-States actors.• The demonstrated links of PHC to betterhealth outcomes, improved equity,increased healthy security and better costefficiency make PHC the cornerstone ofhealth systems strengthening. There isan unprecedented political movementfor health systems to build on thefoundations of PHC which is essentialto achieve universal health coverage(UHC). The new operational frameworkoutlines 14 operational levers thatcomprise all the components of PHC.The expansion of PHC services is one ofthe key accelerators of the health-relatedSustainable Development Goals (SDGs)and the special programme will providedifferentiated support to countries,particularly with fragile health systems.Documents: EB146/5Draft operational framework Primary health care: transforming vision into action• Member States recognised that PHCis a major component to achieve theSDGs and UHC. They also welcomedthe Astana declaration and endorsedthe WHO Global Action Plan for Healthfor All. The DG emphasized politicalcommitment from the highest level iscrucial to push PHC forward and WHO iswilling to provide support to the MemberStates.• The draft decision proposed byBotswana, Brazil, Islamic Republic ofIran, Kazakhstan, Mexico and Tajikistanwas adopted as EB146(18) PrimaryHealth Care.• ICN strongly supports the implementationof the WHO’s special programme on PHC.Nurses make incredible contributions toPHC on a daily basis and are the agentsto effectively engage the community as anactor in the development of interventionsand action. Full ICN statement is he

Agenda Item 7.1: Follow-up to the high-level meetings of the United NationsGeneral Assembly on health-related issues. Universal health coverage:moving together to build a healthier world

Documents: EB146/6Universal health coverage: moving together to build a healthier world

EB146/6 recalled the Political Declarationof High Level Meeting of the Unitednations General Assembly on UHC inSeptember 2019. With the foundationof PHC, UHC is universal access toa strong and resilient people-centredhealth system. In the WHO’s 2019monitoring report, all regions and allincome groups recorded gains, but thepace of progress has slowed since 2010and the progress masks gross inequities.Other monitoring reports also highlightthe significant health challenges affectingthe most vulnerable population groups,for instance, children under five years ofage and pregnant women. The reportsalso call for a sharper focus on people leftbehind and an increase in investmentsin generating high-quality, disaggregateddata to help ensure accountability andprovide countries with vital insights intothe population that is unable to accessessential health services.Documents: EB146/6Universal health coverage: moving together to build a healthier world• Member States recognised UHC ascentral to SDGs and the role of WHO iscritical. Health equity should be focused,especially for vulnerable populations.Health systems should also respondto demographic shifts like ageingpopulations. Some Member Statessuggested providing stronger supportto health care workers. The DeputyDirector General stated that SDG 3.8(catastrophic expenditures and out ofpocket expenditure) has not improvedand it is important for Member States tomobilise national resources. The DG saidit is crucial to take the opportunity to scaleup the action at the country level. The EBnoted the report without objections.• World Health Professionals Alliance(WHPA) Joint statement.

Agenda Item 7.2: Political declaration of the Third High-Level Meeting of theGeneral Assembly on the Prevention and Control of Non-CommunicableDiseases

Documents: EB146/7Political declaration of the third high-level meeting of the General Assembly on the prevention andcontrol of non-communicable diseases / EB146/7 Add. 1 Findings of the consultative process onthe implementation of the global strategy to reduce the harmful use of alcohol and the way forward

The report was submitted pursuant todecision WHA72(11) (2019), in which theWHA requested the DG to prepare andupdate menus of policy options and costeffective interventions to support MemberStates in implementing the actions onthe prevention and control of NCDs.Four separate issues were consideredregarding NCDs: mental health; airpollution; alcohol; and early diagnosisand interventions for NCDs. There is anew WHO roadmap for reducing harmfulalcohol consumption. It was noted thatthere is worldwide increase in harmfulalcohol consumption, particularly in lowand middle-income countries.• Civil society noted that harmful alcoholconsumption claims as many as threemillion lives a year, either directly orthrough cancer, liver disease, heartattack, etc.• Member States expressed concern aboutthe diseases linked to alcohol, suchas cancer. Some also mentioned theimportance of cross-border collaborationto address the harmful use of alcoholeffectively. Draft decision EB146/Conf/1Rev.1 was adopted.• ICN welcomed the strong emphasison mental health promotion in the NCDagenda and fully supports the menuof policy options and mental healthinterventions. Nurses have expertise inholistic, person-centred care and mentalhealth interventions which broadenthe therapeutic outcomes for complexcomponents of chronic illness. Read thefull ICN statement here.

Agenda Item 8: Global Vaccine Action Plan (GVAP)

Documents: EB146/8

The GVAP 2011-2020 was adopted atWHA65.17 in 2012. In 2017, the WorldHealth Assembly expressed concern thatthe progress toward increasing equitableaccess to life-saving vaccines, theeradication of polio, and the eliminationof measles, rubella, and maternal andneonatal tetanus was too slow. ResolutionWHA70.14 (2017) was adopted tostrengthen immunisation to achieve thegoals of the GVAP and requested the DGto report on the epidemiological aspectsand the feasibility of, and potentialresource requirements for, measles andrubella eradication.• EB146/8 reviewed and presented thelessons learned from the GVAP, whichprovided an immunisation vision andstrategy for the decade 2011-2020. Thereport by the Strategic Advisory Group ofExperts (SAGE) stated the implementationof the GVAP was envisaged at countrylevel through the updating of nationalimmunisation plans, supported bydevelopment partners. Towards the endof the decade, regional vaccine actionplans were developed and have playeda key role in bridging the gap in strategyand planning between global and countrylevels. However, the experience suggeststhat elimination goals will ultimatelydepend on strong national immunisationcoverage and the progress relies onthe increase in commitment to achieveequitable immunisation coverage.Documents: EB146/8• With the changing global context andemerging challenges, issues such asgrowing inequities within and amongcountries, demographic shifts, migrationand displacement of people, climatechange and natural disasters, and thespread of misinformation about the safetyand effectiveness of vaccines threatenimmunisation gains need to be addressedwith tailored approaches.• Member States welcomed the reportand showed concerns about vaccinehesitancy and the disruption in supply.Some Member States pointed outstrategic plans should be built on theconsiderations of conflicts and politicalunrest which greatly affect vaccination.The EB also acknowledged defeatingmeningitis by 2030 as one of the fourflagship global strategies to prevent highthreat infectious hazards. The decisionwas adopted by consensus.